TRICARE Formulary: Coverage, Tiers, and 2026 Copays | TRICARE.com

The **TRICARE Formulary** is a comprehensive list of brand-name and generic drugs that TRICARE covers. Managed by Express Scripts, the list determines how much you pay (your copay) and whether you need prior authorization or a medical necessity review before a prescription can be filled.

*Note: TRICARE.com is an independent reference site and is not a government agency. For official policy and the most current drug search tools, visit TRICARE.mil.*

Details

The TRICARE Formulary is divided into four "tiers" or categories. These categories dictate your out-of-pocket costs at retail pharmacies and through the home delivery service.

### 1. Tier 1: Generic Drugs These are drugs that have the same active ingredients as brand-name versions but cost significantly less. They are widely available and always have the lowest copay.

### 2. Tier 2: Brand-Name Formulary Drugs These are brand-name drugs that the Department of Health Agency (DHA) Pharmacy and Therapeutics Committee has determined are effective and cost-efficient. You will pay a mid-level copay for these medications.

### 3. Tier 3: Non-Formulary Drugs These drugs are covered but are not on the preferred list. They come with the highest out-of-pocket costs. However, if your doctor can prove **medical necessity** (i.e., that the formulary drugs would be ineffective or have adverse effects), you may be able to get these at the Tier 2 brand-name price.

### 4. Tier 4: Non-Covered Drugs TRICARE does not pay for certain drugs, such as those used for cosmetic purposes, weight loss (with some exceptions), or medications not approved by the FDA. You are responsible for 100% of the cost for these items.

### 2026 Pharmacy Copayments (Estimated) Pharmacy costs are standardized across TRICARE Select, TRICARE Prime, and TRS. Note that Active Duty Service Members (ADSMs) have $0 copays for all formulary drugs at all locations.

| Drug Category | Home Delivery (90-day) | Retail Network (30-day) | | :--- | :--- | :--- | | **Generic** | $13 | $17 | | **Brand-Name** | $39 | $41 | | **Non-Formulary** | $70 | $78 |

*Exact 2026 rates are subject to final DHA updates; check the TRICARE Formulary Search Tool for your specific medication.*

### The Formulary Search Tool To see exactly where your medicine falls, use the **TRICARE Formulary Search Tool** provided by Express Scripts. It will tell you: * If the drug is covered. * The specific copay based on where you fill it (MTF, Retail, or Mail). * If you need **Prior Authorization (PA)** or **Step Therapy** (trying a cheaper drug first).

## Who this affects * **Active Duty Service Members:** Always $0 copays for covered drugs. * **Active Duty Family Members:** Pay copays at retail and mail-order pharmacies. * **Retirees and their Families:** Highest tier of cost-sharing, especially for non-formulary items. * **National Guard/Reserve:** Includes those on TRS or TRR. * **TRICARE For Life (TFL) Beneficiaries:** Must use the TRICARE pharmacy benefit as primary, even with Medicare.

## Sources * **TRICARE.mil Pharmacy Page:** [https://www.tricare.mil/pharmacy](https://www.tricare.mil/pharmacy) * **Express Scripts TRICARE:** [https://militaryrx.express-scripts.com/](https://militaryrx.express-scripts.com/) * **TRICARE Formulary Search Tool:** [https://www.express-scripts.com/frontend/open-enrollment/tricare/fst/](https://www.express-scripts.com/frontend/open-enrollment/tricare/fst/) * **Defense Health Agency (DHA):** [https://health.mil/](https://health.mil/)